Lin Oscar, Rudomina Dorota, Feratovic Rusmir, Sirintrapun S Joseph
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065.
Diagn Cytopathol. 2019 Jan;47(1):15-19. doi: 10.1002/dc.23925. Epub 2018 Mar 25.
Rapid on-site evaluation (ROSE) with cytology preparations plays a critical role in minimally invasive procedures. The time spent by a pathologist performing ROSE is unpredictable and could be used for more cost-effective activities. The solution encountered by several institutions to address this issue is the use of telecytology (TC). This study analyzes the experience of using telecytology for ROSE in a major cancer center over a period of over 2 years.
A retrospective analysis of all remote TC evaluations for adequacy on fine needle aspiration (FNA) and touch preparations (TP) of core biopsies (CB) performed at a major cancer center was performed. The preliminary adequacy assessment was then compared to the adequacy assessment at final diagnosis.
A total of 12 949 adequacy assessments were analyzed. The most common sites biopsied in our institution were lymph node, lung, and liver. There were 7725 adequacy assessments for CB (59.7%), while adequacy assessment for FNA specimens represented 40.3% (n = 5224) of the total number of specimens evaluated by ROSE. Perfect concordance between initial adequacy assessment and the adequacy assessment at final cytologic diagnosis was 93% (12 049/12 949). The final diagnosis adequacy upgrade rate was 6.7% (n = 863), and the adequacy downgrade (a specimen considered adequate on-site that was determined to be nondiagnostic on final examination) was 0.3% (n = 37).
TC can be easily implemented with the current technologies available. It is cost-effective and allows for better patient care with a more efficient use of the pathologist's time and laboratory resources.
利用细胞学制片进行快速现场评估（ROSE）在微创操作中起着关键作用。病理学家进行ROSE所花费的时间是不可预测的，这些时间可用于更具成本效益的活动。几个机构为解决这一问题采用的方法是使用远程细胞学（TC）。本研究分析了一家大型癌症中心在两年多时间里使用远程细胞学进行ROSE的经验。
对一家大型癌症中心进行的所有关于粗针活检（CB）的细针穿刺抽吸（FNA）和触摸涂片（TP）的远程TC充分性评估进行回顾性分析。然后将初步充分性评估与最终诊断时的充分性评估进行比较。
共分析了12949次充分性评估。我们机构活检最常见的部位是淋巴结、肺和肝脏。对CB进行了7725次充分性评估（59.7%），而对FNA标本的充分性评估占ROSE评估标本总数的40.3%（n = 5224）。初始充分性评估与最终细胞学诊断时的充分性评估之间的完全一致性为93%（12049/12949）。最终诊断充分性升级率为6.7%（n = 863），充分性降级率（现场认为充分但最终检查确定为非诊断性的标本）为0.3%（n = 37）。
利用现有技术可轻松实施TC。它具有成本效益，能更有效地利用病理学家的时间和实验室资源，从而为患者提供更好的护理。
